It is possible to assume the nature of the neoplasm in the body due to clinical and radiological symptoms, but to determine its histogenetic affiliation is possible only thanks to the morphological verification of the diagnosis. The main objective of this diagnosis is to recheck the oncological diagnosis to confirm it and select an effective course of chemotherapy.
Morphological verification
Hearing for the first time from the doctor about the need for morphological diagnostics, many have no idea what this is and why it is being done.
Verification is an important study, without which it is impossible to decide on further actions. Morphological verification is a medical procedure that helps confirm or refute an oncological diagnosis. To conduct research, it is necessary to obtain material. His choice mainly depends on the localization of education. After the study, the specialist, depending on the result, determines the further treatment tactics, which can be conservative or surgical. Only after morphological confirmation can adequate treatment be planned. Indications for verification are volumetric formations or diffuse changes in an organ or its structures. For morphological studies, tissue sampling is carried out as follows:
- with superficial manifest tumors, scraping and smears are taken;
- with shallowly placed nodular formations, puncture is performed;
- if it is impossible to take a puncture, a biopsy is performed with a fence of a tissue site;
- after unsuccessful verification attempts by all of the above methods, an open biopsy is performed.
Morphological verification of the diagnosis is practically no different from cytological puncture. To take the material for research, first, a person is anesthetized with soft tissues and skin, after which a minor skin incision is performed, through which a special instrument is inserted into the soft tissues and directly into the tumor tissue. All subsequent steps are directly dependent on the device used.
Verification Methods
A standard variant of histological verification of the diagnosis is the collection of the finest sections of biopsy tissues for subsequent microscopic examination. Thanks to them, useful information about the composition of the tumor is obtained.
Morphological verification of the tumor is carried out in the following ways:
- histochemistry;
- immunohistochemistry;
- immunofluorescence;
- enzyme immunoassay.
Regardless of which methodology for the study will be chosen, the purpose of verification is not only the determination of the type of tumor, but also the assessment of cell modifications. According to the results of the study, it becomes possible to accurately make a decision and choose treatment tactics.
Histochemical examination
Using the histochemical technique, one can obtain valuable information about the functional activity of the formation, its type and histogenesis. This method allows you to accurately diagnose and solve the problem of its differential.
In the location of histochemistry are numerous reactions that assist in the identification of different classes of substances.
Immunohistochemistry
IHC is a visualization method that helps determine the localization of substances in tissue section preparations. The basis of this method is the principle of the characteristic interaction of antigens with antibodies obtained by a special method.
Immunofluorescence
The research method is based on the sensitivity of fluorescence microscopy and the specificity of the immunological reaction. In the process of its implementation, the tumor tissue is marked with a special dye, which helps the doctor accurately determine the diagnosis. A feature of this method is the simplicity and the need to use the minimum amount of material studied.
Linked immunosorbent assay
The diagnostic method has a high susceptibility and allows you to set the minimum amount of substance. In modern diagnostic methods, it is with this method that the localization of the antigen is determined. For the analysis, special enzymes are used to detect cancer.
Regardless of the method chosen, the goal of any morphological study is to accurately determine the type of tumor and assess changes at the cellular level. It can be said in simple words that morphological verification is the definition of a variety of a tumor and its neglect for the right choice of treatment tactics.
Methods for obtaining material for morphological research
For morphological verification of the diagnosis, it is necessary to obtain material. You can do this in the following ways:
- Trepan biopsy is considered one of the most effective procedures, despite the fact that it has certain disadvantages. To take the material, special needles with internal cutting mechanisms are used. With their help, a column of tissue from the tumor is obtained. This method allows morphological verification of the mammary glands, prostate gland, lung, liver, spine and lymph nodes.
- An incisional biopsy is the most popular method, which is performed using a scalpel, which takes material from the center of suspicious areas around the periphery of the tumor. At the same time, you definitely need to do this outside the zones of edema, necrosis and hemorrhage of granulation tissue.
- Excision biopsy - the essence of this method is the complete radical removal of the tumor. This method is applicable only if the tumor is small. In this case, this method is most preferred, as it has both diagnostic and therapeutic value.
The choice of the method of morphological verification is determined by the attending physician depending on the characteristics of the situation.
The sequence of morphological changes
What is this morphological verification of the diagnosis, and in what sequence changes occur in the process of cancer development, not many know. Unfortunately, mostly people start to be interested in such information only when they encounter a problem.
Oncology in the development process goes through certain stages, and as a result of morphological verification, the doctor can observe different nuances of development. During verification, the following changes in tissues can be detected:
- diffuse and focal hyperplasia - the process is not dangerous and reversible;
- metaplasia - a benign neoplasm;
- dysplasia is a precancerous lesion;
- cancer in situ - preinvasive cancerous lesion;
- microinvasion;
- progressive cancer with metastasis.
The time intervals between the listed stages are individual and in each individual case can vary from several months to decades.
The main task of morphological diagnosis is to establish the tissue affiliation of the tumor. In this case, not only its presence and variety is detected, but also the degree of atypia of the cell and the violation of tissue structures are scrupulously assessed. Most often, morphological verification of the thyroid gland, mammary, prostate, liver, kidneys and spine is performed. The method of conducting research in each individual case is determined personally.